Introduction: Spillage of contents of the dermoid cyst during surgery may cause chemical peritonitis and spillage is more likely to occur during laparoscopic surgery for the removal of the ovarian dermoid cyst. Thorough washing of peritoneal cavity with physiological solution greatly reduces the incidence of chemical peritonitis.Objective: To study the outcome of laparoscopic treatment of ovarian dermoid cysts.Methodology: This is a hospital based cross-sectional study conducted at Birat Medical College and Teaching Hospital from 2012 April to 2016 April. All patients being operated by laparoscopy for ovarian dermoid cysts were enrolled in the study. Occurrence of spillage of dermoid contents during surgery and development of symptoms and signs of chemical peritonitis in postoperative period were main outcome measures. The collected data was entered in Microsoft Excel and analyzed by SPSS software version17.Results: Eighty nine ovarian dermoid cysts from 82 patients were managed by laparoscopy. Among 89 cysts, 54(60.76%) cysts were removed by laparoscopic cystectomy, 21(23.59%) cysts were removed by laparoscopic salpingo-ophorectomy and 14(15.73%) cysts were removed by salpingo-ophorectomy with hysterectomy. Spillage of dermoid content occurred in 50 (56.17%) cysts removal. There was no conversion to laparotomy and no case of chemical peritonitis.Conclusion: The risk of chemical peritonitis is negligible with spillage of dermoid content during laparoscopic procedure when peritoneal cavity is washed thoroughly. Birat Journal of Health SciencesVol.2/No.3/Issue 4/Sep- Dec 2017, Page: 273-276

IntroductionEctopic pregnancy is the most life threatening emergency in first trimester of pregnancy. Laparoscopic methods for treating ectopic pregnancy have made it preferred surgical technique over laparotomy. Most of the ectopic pregnancies can now be treated by laparoscopy.ObjectiveTo study outcome of laparoscopic management of ectopic pregnancy. MethodologyA hospital based cross-sectional study was conducted at Birat Medical College and Teaching hospital from May 2013 to April 2016. The informed consent was taken from patients. The collected data was entered in Microsoft Excel and analyzed SPSS.ResultsAll 89 cases of ectopic pregnancies were managed by laparoscopy. All were tubal pregnancies. Salpingectomy was done in 88 cases and salpingostomy in one case without any significant postoperative complications. There was no maternal mortality and no conversion to laparotomy  ConclusionTreatment of ectopic pregnancy by laparoscopy is effective with decreased postoperative morbidity.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, page: 106-109

Introduction: Although laparoscopy is a safe route of hysterectomy as it provides battier view of abdominal anatomy, facilitates meticulous hemostasis and reduces surgical morbidity, laparoscopic hysterectomy in overweight and obese women may pose an increased risk of intraoperative and postoperative complications as omental fat and limited manipulation of instruments may render operation difficult. Objectives: The aim of the study is to evaluate the impact of Body Mass Index (BMI) on the clinical outcome of total laparoscopichysterectomy. Methodology: This is a comparative cross-sectional study conducted in 190 patients who underwent total laparoscopic hysterectomy (TLH) in Department of Obstetrics and Gynecology of Birat Medical College, Teaching Hospital from July, 2019 to November 2020.Ninety five patients were enrolled in high BMI group and normal BMI group each Result: Mean BMI was 28.90±2.27 ( Kg/M2)in high BMI group and 23.54 ± 1.14 (Kg/M2)in normal BMI group. Urinary tract injury occurred in 4 (4.21%) cases in high BMI group and 2 (2.1%) cases in normal BMI group. Intraoperative and immediate postoperative complication were similar in both groups. Conclusion: Intraoperative and postoperative complications were similar in both the groups. Patients with high BMI have no increased risk of complications during total laparoscopic hysterectomy.

Aims: To assess the surgical outcome of total laparoscopic hysterectomy performed in women with previous caesarean section. Methods: This is a cross sectional analytical study conducted at Birat Medical College, Teaching Hospital from 1 May 2019 to 28 February 2020. One hundred thirty patients undergoing total laparoscopic hysterectomy were categorized in two groups with and without previous caesarean section. The data were entered into Microsoft Excel and analyzed by using statistical package for social studies (SPSS 23.0). Results: The overall complication rate was 3.87% (5/130) with 4.61% (3/65) in previous cesarean section and 3.07% (2/65) without it. Urinary tract injury was the common injury. Mean operating time was slightly higher in previous cesarean section but was not statistically significant. Conclusions: Total laparoscopic hysterectomy can be performed in patients with previous caesarean section without any significant increase in intraoperative and immediate postoperative complications. Keywords: adhesion, caesarean section, hysterectomy, laparoscopic

Background: Pelvic organ prolapse in elder women causes sufficient morbidity and decreased quality of life. Despite age related comorbidities and decreased physiological capabilities, elder women with pelvic organ prolapse may be benefitted by surgical repair via vaginal route.The purpose of this study is to evaluate the safety of vaginal repair of pelvic organ prolapse in women of age 60 years or older. Materials and Methods: This hospital based analytical study was carried out in Birat Medical College Teaching Hospital from September 2020 to September 2021. Fifty-four patients aged 60 years or older with third and fourth degree pelvic organ prolapse were recruited for the study. Necessary information was obtained by self-structured questionnaire and entered into Microsoft Excel. Data was analyzed by SPSS version 22. Results: Fifty-four women with third or fourth degree prolapse with cystocele and rectocele underwent vaginal hysterectomy with anterior colporrhaphy with posterior colpoperineorrhaphy. No organ injury occurred during operation. There was no mortality or severe intraoperative or postoperative complications. Conclusion: Vaginal hysterectomy with pelvic floor repair for pelvic organ prolapse in women of 60 years or older is safe.